Provider Demographics
NPI:1699266445
Name:THE OIL GROUP
Entity type:Organization
Organization Name:THE OIL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND LICENSED THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:WOODBURY
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS, LPCA
Authorized Official - Phone:336-457-2748
Mailing Address - Street 1:1451 S ELM EUGENE ST STE 2009
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-2200
Mailing Address - Country:US
Mailing Address - Phone:336-457-2748
Mailing Address - Fax:336-464-2544
Practice Address - Street 1:1451 S ELM EUGENE ST STE 2009
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-2200
Practice Address - Country:US
Practice Address - Phone:336-457-2748
Practice Address - Fax:336-464-2544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-27
Last Update Date:2018-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20411101YA0400X
NCA13656101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty